Thor Halfdanarson, Professor of Oncology at Mayo Clinic School of Medicine, shared a post on X:
“The Aging Control Nets is finally out in paper!
Does the CAPTEM-PRRT combo perform better than CAPTEM in patients with pancreatic NETs? Well, there is more in this paper than that but let’s focus on the pNETs.
Bottom line: Complex trial, many moving parts, small cohort, does not and should not change practice.
More thoughts:
The study would suggest so with longer PFS in the PRRT/CAPTEM but the bigger question is how patients who got PRRT alone compare but that was not done here. Keep also in mind that the number of treated patients was very small.
The PFS in the PRRT/CAPTEM group was 59.4 months which is very impressive (For PRRT alone reference, it was 20.7 months in OCLURANDOM and 24.5 months in COMPETE). There were only 2 patients (3%) among those who had PRRT who developed therapy-related myeloid dysplasia which is reassuring but also goes against what others have reported where the risk is as high as 10%.
Will this change anything for me? Absolutely not as I would need larger studies to be convinced and also, I am not sure the therapy sequencing matters that much as long as you get all the effective therapy during the illness. But what this study does is to help revive the concept of chemo-PRRT and support the development of other trials looking at combining PRRT with systemic therapy and Aman Chauhan, I am looking at you now… ”
Michael Shusterman, Medical Oncologist, Clinical Assistant Professor, Associate Program Director, Hematology Oncology Fellowship at NYU Grossman Long Island School of Medicine, shared Thor Halfdanarson’s post, adding:
“Would be interested in combination therapy role in very high volume metastatic disease with risk of organ dysfunction (e.g. extensive liver involvement) as a debulking strategy.”
Title: [177Lu]Lu-DOTATATE PRRT and CAPTEM chemotherapy for pancreas and small bowel neuroendocrine tumours: The AGITG CONTROL NETS Multi-centre randomized trial☆
Authors: David L. Chan, Katrin Marie Sjoquist, David Turner Ransom, David Wyld, Kate Wilson, Val Gebski, James Murray, Andrew Ddembe Kiberu, Matthew E. Burge, William Macdonald, Paul Roach, David A. Pattison, Patrick Butler, Timothy Jay Price, Michael Michael, Benjamin James Lawrence, Dale L. Bailey, John Leyden, Simone Leyden, John Raymond Zalcberg, Nick Pavlakis
Read the Full Article.
Other Articles Featuring Thor Halfdanarson on OncoDaily.